Impact of tobacco, alcohol and cannabis use on treatment outcomes among patients experiencing first episode psychosis: Data from the national RAISE‐ETP study

• Published in: Early intervention in psychiatry Vol. 13; no. 1; pp. 142 - 146
• Main Authors: Oluwoye, Oladunni, Monroe‐DeVita, Maria, Burduli, Ekaterina, Chwastiak, Lydia, McPherson, Sterling, McClellan, Jon M., McDonell, Michael G.
• Format: Journal Article
• Language: English
• Published: Melbourne Wiley Publishing Asia Pty Ltd 01.02.2019; Wiley Subscription Services, Inc
• Subjects: Adolescent; Adult; Alcohol Drinking - psychology; Alcohol use; Cannabis; cannabis use; Clinical outcomes; Data recovery; Drug abuse; Early Medical Intervention - methods; Female; first episode psychosis; Humans; Male; Marijuana; Marijuana Smoking - psychology; Mental health; Patient Compliance - psychology; Patient Compliance - statistics & numerical data; Psychosis; Psychotic Disorders - drug therapy; Psychotic Disorders - psychology; Quality of Life; raise‐ETP; Schizophrenia; Severity of Illness Index; Smoking; Tobacco; tobacco use; Tobacco Use - psychology; Treatment Outcome; Young Adult; Youth; first episode psychosis; raise-ETP; alcohol use; tobacco use; cannabis use
• ISSN: 1751-7885; 1751-7893; 1751-7893
• DOI: 10.1111/eip.12542

Aim The primary aim of this study was to examine the effect of recent tobacco, alcohol and cannabis use on treatment outcomes among participants experiencing first episode psychosis (FEP). Methods Secondary data analyses were conducted on 404 participants enrolled in the Recovery After an Initial Schizophrenia Episode—Early Treatment Program (RAISE‐ETP) study. RAISE‐ETP investigated the effectiveness of a coordinated specialty care (CSC) intervention for FEP in community mental health agencies in the United States. Generalized estimating equations were used to examine whether recent tobacco smoking, alcohol, and cannabis use at baseline were associated with illness severity, number of antipsychotic pills missed, psychiatric symptoms and quality of life during the 24‐month treatment period, after controlling for duration of untreated psychosis and treatment group. Results At baseline, roughly 50% (n = 209) of participants reported recent tobacco, 28% (n = 113) alcohol and 24% (n = 95) cannabis use. Tobacco smokers had higher levels of illness severity (β = .24; P < .005), a higher number of missed pills (β = 2.89; P < .05), higher psychiatric symptoms and lower quality of life during treatment relative to non‐smokers. Alcohol users had a higher number of missed pills (β = 3.16; P < .05) during treatment and cannabis users had higher levels of illness severity (β = .18; P < .05) and positive symptoms (β = 1.56; P < .05) relative to non‐users. Conclusions Tobacco, alcohol and cannabis use are common in youth seeking treatment for FEP. Tobacco smoking was associated with more negative clinical outcomes. These findings have implications for including interventions targeting these areas of substance use within current CSC models.